Torrance Memorial’s EHR-ADC interoperability leads to gains in safety, efficiency
Nurses gained more time for patient care and reduced medication discrepancies with interoperability between their EHR and the Omnicell XT Automated Medication Dispensing System.
The Challenge
Torrance Memorial Medical Center is a 443-bed, nonprofit medical center serving the beach cities and surrounding towns of the South Bay area of Los Angeles, and is affiliated with Cedars-Sinai Health System.
Before Torrance Memorial started its transition to a cartless medication distribution model, pharmacy leaders already had anticipated potential nursing workflow issues in the new environment.
They wanted to avoid creating new practice bottlenecks and sought to simplify medication retrieval and administration workflow to allow nurses to focus on the patient, not the technology.
With a view toward providing a holistic patient-centric medication management system, pharmacy leaders sought to standardize processes and reduce:
- Amount of time nurses spend retrieving medications
- Number of medication storage locations
- Complexity of managing multiple patient care systems
Torrance Memorial Medical Center is a 443-bed, nonprofit medical center serving the beach cities and surrounding towns of the South Bay area of Los Angeles, and is affiliated with Cedars-Sinai Health System.
Before Torrance Memorial started its transition to a cartless medication distribution model, pharmacy leaders already had anticipated potential nursing workflow issues in the new environment.
They wanted to avoid creating new practice bottlenecks and sought to simplify medication retrieval and administration workflow to allow nurses to focus on the patient, not the technology.
With a view toward providing a holistic patient-centric medication management system, pharmacy leaders sought to standardize processes and reduce:
- Amount of time nurses spend retrieving medications
- Number of medication storage locations
- Complexity of managing multiple patient care systems
The Solution
Activated Solutions
Pharmacy leaders chose to standardize using an interoperability solution that exchanges information directly between their Cerner Millennium® EHR system and Omnicell Automated Dispensing System. The solution set includes:
- Cerner CareAware iBus™, which provides plug-and-play bidirectional communication
- Omnicell mPage in Cerner PowerChart®, which enables nurses to check medication availability in real time, remotely queue them for retrieval, and remotely document waste
Activated Solutions
Pharmacy leaders chose to standardize using an interoperability solution that exchanges information directly between their Cerner Millennium® EHR system and Omnicell Automated Dispensing System. The solution set includes:
- Cerner CareAware iBus™, which provides plug-and-play bidirectional communication
- Omnicell mPage in Cerner PowerChart®, which enables nurses to check medication availability in real time, remotely queue them for retrieval, and remotely document waste
Getting Closer to Patients
The interoperability between the EHR and automated dispensing cabinet (ADC) changes the way Torrance Memorial nurses view medication management. Dispensing practices shifted to the bedside where a nurse can have a conversation with a patient and have the medications ready for retrieval at the cabinet when needed.
From the Omnicell mPage, nurses can:
- Remotely queue medications for multiple patients
- View alternative medication storage locations
- Remotely document waste
After reviewing the medication availability in the mPage, nurses can communicate with pharmacy from the MAR within PowerChart.
Eliminating redundant workflow steps has resulted in a 52% nurse time savings in medication retrieval.
Now, more than 62% of all nursing medication issue transactions are done remotely through Omnicell’s mPage, with transitional care unit nurses using it 80% of the time.
The interoperability between the EHR and automated dispensing cabinet (ADC) changes the way Torrance Memorial nurses view medication management. Dispensing practices shifted to the bedside where a nurse can have a conversation with a patient and have the medications ready for retrieval at the cabinet when needed.
From the Omnicell mPage, nurses can:
- Remotely queue medications for multiple patients
- View alternative medication storage locations
- Remotely document waste
After reviewing the medication availability in the mPage, nurses can communicate with pharmacy from the MAR within PowerChart.
Eliminating redundant workflow steps has resulted in a 52% nurse time savings in medication retrieval.
Now, more than 62% of all nursing medication issue transactions are done remotely through Omnicell’s mPage, with transitional care unit nurses using it 80% of the time.
Closed-Loop Accountability for Discrepancies
The EHR-ADC interoperability also automatically identifies variances between medications dispensed from the cabinet versus medications documented as administered and/or wasted.
The Torrance Memorial team found the near-100% visibility of potential transaction discrepancies helpful in:
- Improving waste compliance
- Providing individual accountability
- Identifying remedial training opportunities
- Saving time for nursing and pharmacy
The integrated solution also can reveal system gaps, explained Sharon Higgins, Clinical Informatics Pharmacist. “In addition to having better visibility of wasted items that may not be documented properly or documented at all, it also helps identify potential areas for practice improvement,” said Higgins.
“For example, we identified areas that informed a lean management team project in our PACU and how we dispense hydromorphone,” she said.
The EHR-ADC interoperability also automatically identifies variances between medications dispensed from the cabinet versus medications documented as administered and/or wasted.
The Torrance Memorial team found the near-100% visibility of potential transaction discrepancies helpful in:
- Improving waste compliance
- Providing individual accountability
- Identifying remedial training opportunities
- Saving time for nursing and pharmacy
The integrated solution also can reveal system gaps, explained Sharon Higgins, Clinical Informatics Pharmacist. “In addition to having better visibility of wasted items that may not be documented properly or documented at all, it also helps identify potential areas for practice improvement,” said Higgins.
“For example, we identified areas that informed a lean management team project in our PACU and how we dispense hydromorphone,” she said.
The Impact
Key Outcomes:
- Reduced nurse med retrieval time 52%
- Reduced waste discrepancies 78%
- Achieved up to 80% nurse adoption
- Eliminated need for HL7 customization
- Enhanced nursing-pharmacy communication
Customer Benefits:
- Enhanced medication safety (minimize human touches)
- Gained more time for patient care
- Eliminated redundant nurse workflow
"The remote waste feature was an absolute game changer. Nurses don’t have to hunt for a witness and meet at the cabinet to document a waste. They can do it right at their workstations on wheels."
"Our pharmacy technicians also use the mPage to interact with nurses. They review the mPage to verify stock in the unit or an alternate Omnicell cabinet in the unit. They can then message back on the med request, which is part of Cerner’s Enhanced Medication Request functionality."
Sharon Higgins, RPh, Clinical Informatics
